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Increased Mortality with Calcium Channel Blockers?

In what is the largest study by far to explore the possibility of adverse effects associated with calcium channel blockers, researchers from the Nurses' Health Study examined outcomes in 14,167 women with hypertension treated with calcium channel blockers, thiazide diuretics, ß -blockers, or ACE inhibitors in 1988.

By 1994, 385 women had suffered a first cardiovascular event. After adjustment for cardiovascular history and other risk factors, calcium channel blockers were associated with a 64 percent increase in risk for myocardial infarction, relative to women on diuretics alone. Among women with no history of cardiovascular disease in 1988, calcium blockers were associated with a 65 percent increase in risk for myocardial infarction. Risks were higher among women who used calcium channel blockers in combination with other antihypertensive agents. Multivariate analysis also found increased risk for total mortality among calcium channel blocker users.

Comment: This prospective study must be interpreted with caution because it does not reflect the predominant use of long-acting calcium blockers today. However, it is not reassuring for those who hope calcium channel blockers might improve the prognosis for women with hypertension.

— TH Lee

Published in Journal Watch General Medicine May 1, 1998

Citation(s):

Michels KB et al. Prospective study of calcium channel blocker use, cardiovascular disease, and total mortality among hypertensive women: The Nurses' Health Study. Circulation 1998 Apr 28 97 1540-1548.

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